Orange County’s COVID-19 positivity rates continue to decline and hospitalizations remain stable, but a prominent UC Irvine epidemiologist Friday said residents should brace themselves for another wave of coronavirus this winter.

The county, which provides updates on Thursdays, reported that hospitalizations went from 113 patients on Oct. 20 to 118 as of Wednesday, according to the Orange County Health Care Agency. The number of intensive care unit patients went from nine to 14.

“We’re holding steady from last week,” Andrew Noymer, an epidemiologist and UC Irvine professor of population health and disease prevention, told City News Service Friday. “We’re clearly still low in terms of hospitalizations — we’re clearly still in a lull.

“I’m happy to report that we’re in a lull, but we really still don’t know what’s going on because everyone is doing at-home tests if they’re testing at all. We really only know about the severe cases, and what we do know is the severe cases are low, but it doesn’t mean that COVID has gone away. It just means the severe cases are low.”

Noymer noted, “We’ve seen this in the previous two falls. We’ve seen this before, so people should be wary as we head into the winter that it will continue to ramp up.”

Compounding things is a rise in flu and RSV cases, Noymer said. There’s a debate going on among scientists as to why there has been an increase in other viruses, he added.

Some scientists hypothesize that it is due to what is known as “debt immunity,” and others argue for hypoimmunity.

“Debt immunity” occurs when something interrupts the spread of viruses and leads to a catching up in cases later. People build up an immunity each year with an infection and may not be infected again the following season. The social distancing and masking, it has been argued, reduced infections during the pandemic, so now that may explain the rise in cases this fall.

“The flu chickens are coming home to roost, so to speak,” Noymer said.

“Hypoimmunity is basically that COVID does a number on our immune systems and either permanently or temporarily — probably temporarily — we’re more susceptible to infections now,” Noymer said.

“The acid test could be next year, because next year we can’t keep saying its immunity debt,” Noymer said. “But we may never be able to distinguish between these two theories. We may never really know.

“If flu gets progressively worse every season it might be COVID is doing permanent damage on immune systems, but I think that’s overly pessimistic. It’s complicated even further that people are getting COVID multiple times.”

The county has 22% of its intensive care unit beds available. Officials grow concerned that percentage drops below 20%.

Of those hospitalized 68.5% are incompletely vaccinated or unvaccinated and 69.3% of the COVID-19 patients in intensive care units are incompletely vaccinated or unvaccinated.

The county logged 1,136 cases for the week, increasing the cumulative case count to 673,169.

The county’s test positivity rate went from 5.9% last week to 5.3%, with the statistic going from 5% to 4.7% in the health equity quartile, which measures the communities hardest hit by the pandemic. The daily case rate per 100,000 dropped from 5.4 to 4.7 on seven-day average with a seven-day lag, and fro 5.6 to 4.9 in the adjusted daily case rate per 100,000 on a seven-day average with a seven-day lag.

The county logged 23 more fatalities, boosting the cumulative death toll to 7,518. Eighteen of the fatalities happened this month, increasing the death toll for October to 30. Three fatalities occurred in September, raising that month’s death toll to 68. And two happened in July, raising July’s death toll to 129.

The positivity rate for those fully vaccinated with a booster went from 5.7 on Oct. 16 to 5.8 on Oct. 23, according to the latest data available. For those vaccinated with no booster the rate went from 2.4 to 2.8. For those not vaccinated the rate went from 7.3 to 5.9.

The number of residents fully vaccinated went from 2,355,864 to 2,357,219. The number of residents who have received at least one dose is 213,254. The number of booster shots administered increased from 1,380,989 to 1,402,418.

The number of children up to 4 years old, who have received at least one dose is 15,132 with 7,714 fully vaccinated. Just 4.1% of the county’s population in the age group is fully vaccinated.

For 5- to 11-year-old children, 96,915 are fully vaccinated, about 36.6% of the age group. In the 12-to-17 age group, 69.8% are fully vaccinated.

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